Position Summary

 

The Medical Only Adjuster is responsible for prompt handling of less complicated (impairment income benefits only) indemnity and medical only workers' compensation claims. This position demands strict confidentiality, excellent attention to detail, documentation skills and the ability to meet deadlines and turnaround standards.

 

Functions and Responsibilities

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  Must hold proprietary/confidential information/knowledge with utmost discretion
  
  
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  Review new assignments; insure correct coding on the RMIS, set reserves, request medical, set follow up diary
  
  
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  Review files on diary, review medical reports and determine if file can be closed, if not, set follow-up diary
  
  
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  Review and respond to any correspondence or inquiries related to caseload
  
  
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  Review closed files pulled for review of payment of medical bills and/or other activity; determine if file should be reopened
  
  
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  Take recorded statements on claim files where activity is warranted
  
  
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  Coordinate referral of claims for peer review, rehabilitation, independent adjusting firm, etc, with vendors
  
  
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  Participate in special projects as requested by the PC Team Leader and Supervisor; provide status on progress of project
  
  
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  Routine client contact, particularly with those clients who, because of the limited activity generated, have not been contacted in the last 30 days
  
  
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  Maintain current adjuster's license and fulfill continuing education requirement

 

Requirements

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  High School diploma or equivalency; college curriculum preferred
  
  
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  Must have Adjuster's license (series 03) or All-Lines license (series 08)
  
  
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  Minimum of one year workers’ compensation claims handling experience
  
  
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  Specific knowledge of Texas Workers' Compensation Act and rules promulgated by the Division of Workers’ Compensation or demonstrated ability to master same
  
  
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  High degree of self-direction, investigative ability and sound judgment
  
  
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  Moderate personal computer skills including familiarity with proprietary software/databases used in the TPA industry

 

 

If you are interested in applying to this position, and learning more about JI Companies, please visit our website at www.jicompanies.com.

 

 

*JI Specialty Services, Inc. is an Equal Opportunity Employer. M/F/D/V encouraged to apply. Qualified applicants will receive consideration without regard to age, race, color, religion, sex, disability, or national origin. Applicants encouraged to confidentially self-identify when applying. Employment contingent upon successful completion of background investigation. Smoke-free workplace. Drug-free work environment. Environmentally-responsible business. No faxes please. Must be eligible to work in this country. Unable to sponsor or transfer H1 visas at this time. No phone calls please.